What is Plantar Fasciitis?
Plantar fasciitis is a painful condition of the heel resulting from damage and thickening of the tissue on the underside of heel bone.
The plantar fascia is a thick fibrous ligament that runs under the foot from the heel to the toes. It helps form the arch of the foot and plays an important role in the natural shock-absorbing mechanism of the foot. The plantar fascia is not very elastic and has very limited capacity to stretch. Micro tears can occur if too much traction or load is placed on the plantar fascia. This results in irritation, inflammation, swelling, thickening and pain.
What symptoms do I get if I have plantar fasciitis?
Pain from plantar fasciitis is often felt under the heel. Although some people may have pain under the arch of the foot. The pain is more intense with the first steps of the day or after resting for a while. While resting, the ligaments and muscles shorten and tighten up. Tightening of the plantar fascia results in more traction on the ligament when weight is put through the foot. This makes it more sensitive, resulting in a stabbing pain.
The ligament warms up and becomes a little more flexible after walking around for a while. This can settle the pain or reduce it to a dull ache. However, after excessive walking or standing for long periods of time, the pain can return.
What can cause or contribute to plantar fasciitis?
Over use – too much sports, running, walking or standing for excessively long periods
Excessive weight gain – every step can put up to 4 times your body weight through your feet. Feet are designed to carry a certain amount of weight. As a persons gains weight, greater loads go through feet.
Age – as people get older the collagen changes and becomes less elastic. This reduces the ligaments and tendons abilities to cope with load.
Unsupportive footwear – shoes that don’t provide adequate arch support. Barefoot walking, especially on hard surfaces
Flat feet or over pronation of the foot – if the foot excessively pronates (rolls in, collapsing the arch and elongating the foot). The unnatural elongations with every step taken places excessive loads and strain through the plantar fascia.
Tight calf muscles – the calf muscles have a major role in absorbing load through the foot. Tight calf muscles will increase the load through the foot and plantar fascia
In most cases plantar fasciitis will settle down on its own. If some simple measures are taken to help reduce the loads on the plantar fascia, resting and reducing the inflammation will help improve symptoms.
What can you do to help your heel pain?
- Reduce your level of activity and stress on the foot (stop walking or running/ standing for long periods
- Obtain good arch and foot support with appropriate orthotics and comfortable foot wear with soft cushioning on the heel
- Stretch the calves every day to improve the range of movement in your ankle
- Pressure ice massage of the foot for 30 to 40 minutes every night will help reduce swelling and inflammation in the fascia
- Simple pain relief/ anti inflammatory (Panadol/Nurofen)
What are my options if the simple measures don’t improve my plantar fasciitis?
At Advanced Sports Clinic, we offer multiple treatment options which can improve and help hasten your recovery:
Helps reduce the inflammation around the fascia and reduce the pain associated with plantar fasciitis. It does not however treat the cause or help the fascia heal. It is simply about symptom control. To find out more about Cortisone injections please press here.
Shockwave therapy (lithotripsy)
This is a specialised target therapy to the plantar fascia. This will stimulate a healing response in the plantar fascia. In time may help reduce the inflammation and pain. This consists of 3 consecutive treatments, one week apart for 3 weeks. The patient is then reviewed 4 weeks following the final dose. If symptoms persist, a further 2 treatments will be given, weekly for 2 weeks. The full effects of this treatment are usually seen at about 3 months. This has been shown to be an effective non-invasive treatment option. Particularly for chronic plantar fasciitis which has not responded to any other type of treatment. To find out more about shockwave therapy please press here.
Platelet Rich Plasma injection (PRP)
This is a new treatment option for plantar fasciitis. The patient’s own blood is used and is injected into the plantar fascia. A recent study has shown this to be extremely effective in treating plantar fasciitis. In our clinic we have noticed that PRP has been very effective in treating plantar fasciitis, especially in chronic cases. By 4 weeks after the injection, most patients notice a significant reduction in the sharp pain they experience first thing in the morning or after long periods of rest. The dull ache/pain can take up to 3 months to settle. To find out more about PRP injections, please press here.
To view the recent research in the use of PRP injections in plantar fasciitis please press here.
Like any condition, there are 1000’s of different treatment options described, offered and provided by any number of people out there. However we have found that the treatment options described above have had a significant success rate in our patients. Unfortunately there is no one magic bullet that can be offered to everyone with plantar fasciitis that will have a 100% success rate in everyone. It is about activity modification and combining non-invasive, simple measures with either shockwave and/or PRP injections to help reduce symptoms, encourage healing and hasten the recovery of plantar fasciitis.
In the rare event that the above treatments fail to help improve your plantar fasciitis, we can refer you to a highly skilled foot and ankle surgeon for review and subsequent surgical treatment.
For further information or to make an appointment to see our Sports Doctor please call 3831 8888.